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Cardiac enzymes

Discussion in 'Emergency Medicine' started by HumidifiedMoistureExchange, Jul 20, 2006.

  1. Direct Laryngoscopy

    Direct Laryngoscopy Account on Hold
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    Quick question.

    When You have a pt come in as code 66 (CVA) is it standard to get cardiac enzymes on all these pts. or do you only do it for pts. with co-morbidities (HTN, CAD, DM, etc.), or do you just get a set to appease the service the pt will be admitted to (Neurology, Medicine, ICU)? Whats you reasoning for doing or not doing the tests? (Just interested)


    Thanks in advance yo
     
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  3. margaritaboy

    margaritaboy Senior Member
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    There is a significant number of people with CVAs that have coexisting acute cardiac ischemia. I don't really know why this is true, but it is. Elderly patients will frequently present with a change in mental status as an initial sign of AMI.

    Consider your CVA and elderly patients at high risk for cardiac ischemia, and get some enzymes.
     
  4. SoCuteMD

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    In the ED I spend time in we don't order anything purely to appease the service the patient will be admitted to. If it's indicated and they would like it, we'll order it.

    Ha, I say "we" as if my name appears next to any order. :p

    With that said, I don't know the answer to your question.
     
  5. Direct Laryngoscopy

    Direct Laryngoscopy Account on Hold
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    The reason I ask is because I have seen attendings (and residents) from other services practically demand that the ED attending (or resident) order a certain lab or test, before admission to a service. More often then not (from my own experience), the ED doc does the test. Nothing outrageous like nuclear med or MRI but on a smaller scale
     
  6. SoCuteMD

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    Yeah, I know it's that way at a lot of places. The place I work is, uh, "resource-limited" so we only do what is absolutely necessary. Let Internal Medicine run up their budget if they want to order unnecessary tests :p.
     
  7. NinerNiner999

    NinerNiner999 Senior Member
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    Keep in mind also that the CK-MB contains a fraction of BRAIN markers in it as well, and can be elevated during cerebral infarction just like in myocardial infarction...
     

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